This blog is totally independent, unpaid and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.

Saturday, November 10, 2012

Weekly Overseas Health IT Links - 10th November, 2012.

Note: Each link is followed by a title and few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.

FRANKFURT (Reuters) - Software engineers are moving to the fore in the war on cancer, designing programmes that sift genetic sequencing data at lightning speed and minimal cost to identify patterns in tumors that could lead to the next medical breakthrough.

Their analysis aims to pinpoint the mutations in our genetic code that drive cancers as diverse as breast, ovarian and bowel. The more precise their work is, the better the chance of developing an effective new drug.

Ever since James Watson and Francis Crick discovered the structure of DNA in 1953, scientists have been puzzling over how genes make us who we are. The confluence of computing and medicine is accelerating the pace of genetic research.

With the support of health information technology, astute preparation by staff and, yes, even some good old-fashioned luck, hospitals and health systems along Hurricane Sandy’s path emerged from the storm relatively unscathed.

Officials at Atlanticare, one of New Jersey’s largest healthcare systems, based in Galloway and Atlantic City, N.J., cite early preparation among IT and safety staff as key to surviving this kind of storm.

“I had actually been tracking the weather the week prior,” Debra Fox, chief safety office at Atlanticare, tells Healthcare IT News. “Thursday is actually when we initiated our planning and communication to the leadership around beginning to put their operational preparedness plans in place,” she adds. This included topping off generator fuel and ensuring that the facility is able to withstand a loss of power.

Right in the thick of this year's presidential election season, the House of Representatives and the Senate have raised questions about the effectiveness of the Meaningful Use incentive program. The former went so far as to call the program "weak" and "a waste of taxpayer dollars," in a letter sent to U.S. Department of Health & Human Services Secretary Kathleen Sebelius on Oct. 4.

To that end, we at FierceHealthIT wonder how the election will impact the industry once the dust settles next Wednesday (assuming the dust does settle by then). We asked our FierceHealthIT Advisory Board members to share their thoughts on how the election results--either way--will impact health technology professionals.

Although a new report on improving and accelerating the coordination of care does not explicitly say so, a former head of Kaiser Permanente who helped draft the paper believes that it is nearly impossible to achieve the goals of care integration in the absence of well-designed IT systems.

The next wave of opportunity for electronic health record vendors may be in Europe, according to a recently published report from Kalorama Information.

EHR adoption varies considerably in Europe. The Nordic countries have been using the technology for more than 10 years, but adoption in the U.K., Germany, France and Spain is "on course" with adoption in the U.S., according to the report.

ROCHESTER, NY – When the Rochester RHIO was established in 2006 to improve the quality and efficiency of care in the greater Rochester, NY, area, one of the requirements from a local matching grant was to enable diagnostic-image sharing among healthcare providers.

Since July 2009, the nonprofit, community-run organization has offered this service, first receiving images from a few and then expanding to include 11 participating radiology practices.

In 2013, Rochester RHIO expects to complete studies it has been conducting on changes in clinical care based on HIE access to images.

PARSIPPANY, NJ – A new global study by the IMS Institute for Healthcare Informatics shows that the use of healthcare IT to increase medication adherence could be a key factor in saving some $500 billion in healthcare spending worldwide.

Murray Aitken, executive director of the IMS Institute says the study shows that policies and practices that govern the use of medication are an essential and under-appreciated piece of the global healthcare puzzle.

“Harnessing available information to set priorities, monitor progress and support behavior change among healthcare stakeholders – including policymakers, payers, clinicians, nurses, pharmacists and patients – is a vital first step,” he said.

A new approach to algorithmically distinguishing words with multiple possible meanings could help find useful data in electronic medical records.

Larry Hardesty, MIT News Office

October 31, 2012

In the last 10 years, it’s become far more common for physicians to keep records electronically. Those records could contain a wealth of medically useful data: hidden correlations between symptoms, treatments and outcomes, for instance, or indications that patients are promising candidates for trials of new drugs.

Much of that data, however, is buried in physicians’ freeform notes. One of the difficulties in extracting data from unstructured text is what computer scientists call word-sense disambiguation. In a physician’s notes, the word “discharge,” for instance, could refer to a bodily secretion — but it could also refer to release from a hospital. The ability to infer words’ intended meanings makes it much easier for computers to find useful patterns in mountains of data.

The American Health Information Management Association has outlined core clinical documentation guidelines for coding medical diagnoses and procedures in 2013 and 2014.

In a new white paper, AHIMA says healthcare providers should have a "high integrity" coding compliance policy that should be updated at least once a year. The paper provides guidance on identifying source documents as a designated clinical documentation set.

Although AHIMA has issued guidance for compiling a coding compliance document, it has not previously defined what core medical record documents or clinical documentation should be used, according to the paper.

CLEVELAND, Ohio -- Bariatric surgery to control diabetes has been selected as the No. 1 innovation by doctors at the Cleveland Clinic.

The Top 10 medical innovations for 2013 will be announced this afternoon at the Clinic's 10th annual Medical Innovation summit. They were selected from 150 nominations of emerging technologies, gathered from more than 110 Clinic experts. The innovations had to have a high probability of commercial success.

According to a new study published in the Journal of Medical Internet Research, wikis would be an effective participatory tool for patients in the development of a clinical practice guideline. Wikis, which are user-friendly websites that allow readers to put in their own modifications of content with a simple text editor, were tested by researchers looking to create clinical guidelines for infertility treatment.

The researchers wanted to see how many people would visit the wiki, what the benefits would be, and what helped and hurt adoption. In order to create the initial wiki, the Netherlands-based researchers interviewed 12 patients and created 90 recommendations onto a wiki.

NEW YORK – The Statewide Health Information Network of New York (SHIN-NY) sees itself as a "public utility" as much as an HIE. In the wake of Hurricane Sandy, as patients bounce between hospitals (and as other public utilities, such as electricity and transportation, are compromised), it has enabled critical continuity of care.

The images of dozens of red-flashing ambulances, evacuating as many as 200 patients – some of them in critical condition, some of them infants – from NYU Langone Medical Center, whose backup generator had failed, to hospitals such as Sloan-Kettering and NewYork-Presbyterian, will be some of the most enduring images from the super storm.

The harrowing process was made much smoother by the fact that those patients' electronic health records were secure and readily accessible at the hospitals to which they were transported, thanks to New York's statewide HIE.

The Office of the National Coordinator for Health Information Technology has a new challenge for software developers: ONC is calling on graphic designers to figure out ways to make electronic health records more “readable.”

Scott Mace, for HealthLeaders Media , October 30, 2012

I've been a part of some great healthcare technology discussions while at HealthLeaders Media, but perhaps none covered more ground and got to the heart of more issues in less time than a meeting last week between some of Silicon Valley's top healthcare entrepreneurs and four top executives—three of them CEOs—representing healthcare providers with a Valley presence.

Hosted by the University of California, San Francisco, this 100-minute meeting of minds got right to the promise and the pitfalls of technology in healthcare, and highlighted just what an inflection point we've reached as 2012 draws to a close.

For one thing, I was struck by how many hospitals are taking selected tech startups under their wing, offering business advice and intimate glimpses for a lucky few developers into their particular workflow challenges.

There will be no “big bang” in 2015 when 13 million Ontarians’ electronic health records are all suddenly turned on. It’s happening now, each and every day. More than 9 million Ontarians already have an electronic health record.

Three years ago this month the auditor general of Ontario issued a report highly critical of eHealth Ontario’s progress, spending, and lack of strategy. Since then, a new management team and board of directors have been working to turn around the agency and deliver real progress.

The Agency for Healthcare Research and Quality is launching a study to better understand how implementation of health IT affects clinical workflow, reportsHealthData Management.

"The goal of the project is to understand the impact of implementing health IT-enabled care coordination on workflow within small community-based primary-care clinics in various stages of practice redesign," it says in a notice published Wednesday in the Federal Register.

Massachusetts Institute of Technology researchers are working on algorithms to better distinguish the meaning of words that might be used in multiple ways--a common occurrence in healthcare, reportsMIT News.

Since so much data is buried in physician notes, for instance, the implications for advancing natural language processing are huge. The problem lies in "word-sense disambiguation"--determining, for example, whether "discharge" refers to a bodily secretion or release from a hospital.

The researchers, from MIT's Computer Science and Artificial Intelligence Laboratory, will present their new system next week at the American Medical Informatics Association's annual symposium in Chicago.

Speaking Tuesday at a Senate panel hearing on prescription drug abuse, doctors and law enforcement officials touted the importance of agencies sharing information to more effectively look for pharmacies and doctors involved in the usage of prescription drugs outside of medically sanctioned purposes.

Despite the recent passage of tougher penalties, prescription drug abuse has continued to be a problem, speakers said Tuesday. But doctors told lawmakers that many involved in prescription drug abuse are not drug dealers but addicts who first got a prescription for legitimate pain.

Liaison Healthcare, a division of the Atlanta-based data management firm Liaison, is launching a cloud-based Master Person Index (MPI) platform that helps providers with meaningful use and health information exchange use cases.

The cloud-based MPI solves several problems that have been a drag on the pursuit of interoperability, Liaison Healthcare's VP of healthcare solutions Gary Palgon said in a press release. With some MPIs still using legacy processes for patient and provider identifications, some providers have been struggling with data system integration and information exchange, resulting in inefficiencies like duplication, Palgon said.

Here's a news flash that might cool down physicians' fever for the new iPad mini from Apple, which slips inside the pocket of a white lab coat: Clinicians in 70% of healthcare organizations look up electronic health records (EHRs) on smartphones and tablet computers, but they find it hard to enter data on the small screens of these hot devices, according to a new report from the research firm KLAS.

"Our physicians are accessing [the EHR] largely to view data," a representative of one organization told KLAS in a survey on mobile devices. "When the [iPad] keyboard pops up, it covers two thirds of the screen and makes it nearly impossible to efficiently document."

There is clearly no doubt that healthcare and IT jobs are the fastest-growing in the market. When you combine those categories into health IT jobs, fastest-growing actually means shortage – for managers that means hard-to-find and hard-to-keep good people.

How is it that some leaders seem to have a revolving door, and some are able to keep employees over an entire career?

The people will vary, but leaders need to look at themselves – they are the constant in the retention equation. One theory is that leaders are “emotionally contagious” – if you are happy and like your job, well, then, your people will be happy and like their jobs.

At the same time the government is encouraging healthcare providers, doctors and insurance companies to digitize healthcare information, the landscape for attacking that info is increasing dramatically. Data beaches occur routinely, but data security experts warn about the vastly higher cost of waiting until a breach occurs, than doing the upfront work to prevent it.

"A security breach is an incredibly expensive problem," said Danny Creedon, managing director at Kroll Advisory Solutions, a company that deals in risk mitigation and response. "There's significant cost surrounding investigation, notification, remediating what occurred and putting in to place services like credit monitoring and identify theft service monitoring that have a monthly cost per person and remain in effect for some time.

"Unfortunately," he added, "most healthcare organizations don't take data security seriously until there's a breach," continued Creedon. "They never seem to have funds available to appropriately support a data security program until they actually have a breach. Then the funds seem endless."

The Supercomputer known as Watson will help medical students at Cleveland Clinic to analyze medical problems and develop evidence-based solutions.

The IBM natural language processor, meanwhile, will be building its base of medical knowledge and improving its Deep Question Answering Technology, making it a more valuable partner to future physicians, according to an announcement from IBM. Another goal will be using Watson to process an electronic medical record "based on a deep semantic understanding of the content within an EMR," the computer-maker says.

You might remember Watson as the computer that beat two Jeopardy! champions last year, sorting through its reams of knowledge to respond to oral questions from host Alex Trebek. Watson wasn't perfect: It responded "Toronto" to a Final Jeopardy! question about U.S. cities with airports named after World War II heroes.

DALLAS – Even as nearly everyone is using smartphones and tablets for critical information, few organizations have taken steps to keep the devices safe from cyber threats, according to a new survey from the Polytechnic Institute of New York University and AT&T.

A full 90 percent of respondents allowed employees to access work email via mobile devices, and 41 percent say they allow their employees to access important files via mobile devices, according to the study.

But just 65 percent reported that information and data security of wireless devices was a concern – even as 91 percent of respondents said they were concerned about computer and online data security. Fewer than one-third (29 percent) have installed anti-virus software on smartphones.

NEW YORK (Reuters Health) - There's no shortage of websites with information on prostate cancer treatment, but they may be well beyond the average person's comprehension, a new study finds.

The study, of 62 such websites, found that only three had treatment information written below a 9th-grade reading level. Most often, sites aimed for the reading level of a high school senior - far beyond the reading skills of many Americans.

That's a worry, researchers say, because there is a range of treatment options for prostate cancer. And if men are going to make good choices, they need to understand the information out there.

Responding to disasters is something every healthcare institution needs to be ready for. From hurricanes to snowstorms to wildfires, having a plan in place and technology to back it up is critical to an effective response.

During these times of crisis many simple things, such as contacting relatives of patients or ordering crucial supplies can become major headaches if an adequate plan is not arranged beforehand. As many healthcare centers employ a higher than average concentration of IT equipment, there are certain ways they can leverage them to cope with disasters- and things they must do to safeguard their technology as well.

Mike Detjen of Arcadia Solutions speaks about some of the must-haves for HIT in disaster scenarios – ways it can be useful and things to be concerned about.

The Indian Health Services is building a first-generation personal health records system to serve more than 2 million beneficiaries.

The PHR will be populated with data from HIS’ existing clinical, administrative and billing information systems. Patients will have the ability to access via the Web and print a subset of their health information.

Jazz buffs might readily recognize Duke, Ella, Thelonius and Billie as the names of four of the all-time greats in that musical sector. But those monikers are also the names of the members of a virtual family -- two adults and two children -- being used by FDA to potentially improve the safety of devices and drugs before they hit the market.

These virtual patients are basically high-resolution, magnetic-resonance images of healthy volunteers, complete with organs, bones and other tissue. Created using computer-aided design to comprise FDA's "Virtual Family Tool," the models are being used to assess the safety and efficacy of medical implants and devices, and radiologic imaging.

"The virtual physiological patient is our model for taking this work forward to come up with a coherent set of models for key organ systems that can be used to design devices, and eventually tailor therapies to individual patients so that their physiology can be plugged into these models," Michelle McMurry-Heath -- associate director for science in FDA's Center for Devices and Radiological Health -- said.

SAN ANTONIO – It’s not what you say that matters — it’s what you do and how you use it.

So goes the motto blanketing all professions and endeavors, from campaign trails on down to the compassionate acts of ideal citizenry, where the candidate meets an elderly woman and a passerby helps her across the street. In the healthcare technology world, this pay-it-forward mantra demands amplification; it must remain constant and pressing, it must take-it-forward. There is no time to fumble around for the correct change.

Instances of EHR transitions have a tendency to muddle such advancement, plateauing some practices and putting them at risk for fraud investigations and medical liability issues. The reins often get tossed and the practice inevitably loses itself where it could easily thrive.

Patients can play a key role in developing clinical practice guidelines (CPG) through a specialized wiki, a group of Dutch researchers report in the current issue of the Journal of Medical Internet Research.

The researchers tested their theory by developing a wiki about infertility treatment, according to the article, "Feasibility of a Wiki as a Participatory Tool for Patients in Clinical Guideline Development."

Initial content of 90 recommendations was developed following in-depth interviews with 12 patients. Over a seven-month period, additional patients were invited to participate in the wiki, resulting in 298 unique visitors to the website and 289 recommendations. The recommendations were winnowed down, with a guideline development group assessing their value.

Dossia, a vendor of personal health records and related tools for large corporations that offer the technology to employees, has introduced an online health consumer social network and resource center that is free to everyone.

Beginning in 2014, the reporting of clinical quality measures will change for all providers. Electronic health record (EHR) technology that has been certified to the 2014 standards and capabilities will contain new CQM criteria.

NHS 24 has committed to launch all telehealth solutions on three channels - smartphones, tablets and digital TV.

NHS Scotland’s online and telephone-based advice service has also committed to only launch telehealth solutions that are able to support multiple conditions.

“Scotland won’t deploy any solution that manages just one condition on telehealth,” NHS 24 medical director Professor George Crooks told the Healthcare Efficiency through Technology conference in London last week.